Can we borrow your intervention? A randomized controlled trial of an older adult telehealth wellness promotion program in middle-aged adults with physical disability.
Ivan R Molton, Katie Singsank, Nova Rivera, Leah Munroe, Aaron Flaster, Andrew Humbert, Deidre Daymon, Meghan Thompson, Bishan Yang, Paige Denison
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引用次数: 0
Abstract
Background and objectives: The widespread availability of evidence-based, community embedded health promotion programs for older adults represents a major achievement in gerontology. Many of these programs may also be suitable for younger adults with early-acquired disability, creating an opportunity to leverage existing resources and networks. However, the evidence base supporting these programs has often excluded people with early-acquired or long-term disability.
Research design and methods: This project represented a "bridging" partnership among a group of academic disability researchers and a community service organization serving older adults. The team identified an existing health coaching program for older adults (EnhanceWellness), engaged in a formal adaptation process, and conducted a 3-arm randomized controlled trial in 505 middle-aged adults with long-term, physical disability. Participant reported outcomes (mood, community participation and self-efficacy) were assessed at baseline, mid-intervention (3 months), post-intervention (6 months) and 12 months, utilizing PROMIS measures. Enhance Wellness was compared to health education or treatment as usual.
Results: Participants were middle-aged (M=55.8 years) and primarily women (79%), who had lived with a disability-associated health condition for an average of 23 years. Linear mixed effects modeling suggested superiority of Enhance Wellness in increasing participation outcomes, and effects were maintained at the 12-month follow-up. Intervention effects were partially mediated by improvements in disease management self-efficacy. There were no significant treatment effects on depression.
Discussion and implications: Results emphasize the potential for adaptation as a strategy to extend the existing network of older adult interventions to serve those living with long-term disability.
期刊介绍：
The Gerontologist, published since 1961, is a bimonthly journal of The Gerontological Society of America that provides a multidisciplinary perspective on human aging by publishing research and analysis on applied social issues. It informs the broad community of disciplines and professions involved in understanding the aging process and providing care to older people. Articles should include a conceptual framework and testable hypotheses. Implications for policy or practice should be highlighted. The Gerontologist publishes quantitative and qualitative research and encourages manuscript submissions of various types including: research articles, intervention research, review articles, measurement articles, forums, and brief reports. Book and media reviews, International Spotlights, and award-winning lectures are commissioned by the editors.
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